Kornimate/medical-research-clean huggingface dataset:
hartmann's solution and normal saline in type ii diabetes patients

Conditions: Diabetes Mellitus, Type 2

Summary: the purpose of this study is to determine whether perioperative use of hartmann's solution in type ii diabetes patients increases blood glucose level after surgery. the investigators expect the result to broaden the choice of fluid for diabetic patients and hopefully to diminish the side effects manifested by the excess use of normal saline.

hyperglycemia is an independent risk factor for poor outcomes in diabetic patients experiencing sudden cardiac death, myocardial infarction, cerebrovascular accident. during surgery, activation of the neuroendocrine system by surgical stress releases stress-induced hormones such as cortisol, glucagon, epinephrine, and growth hormones and it leads to hepatic glucogenesis and glycogenolysis. acute perioperative hyperglycemia induces decreased microvascular reactivity to dilatory agents like bradykinin, increased inflammatory cytokines, and impaired neutrophil activity. this impaired neuroendocrine and immune system leads to increased inflammation and multiple organ system dysfunction. thomas and alberti showed postoperative use of 1 litre of hartmann's solution was associated with a 7.5 mmol/l increase in plasma glucose concentrations, compared with an increase of 2.1 mmol/l in diabetic patients who received no intravenous fluids. since then, normal saline has been preferred over hartmann's solution in fear of acute hyperglycemia during postoperative period. however, a recent review suggested that the maximum increase in glucose concentration with 1 l of hartmann's solution would be about 1 mmol/l (about 18 mg/dl) ,with a much lower effect on blood glucose in clinical practice. in fact, according to 2012 national health services (nhs) diabetes guideline for the perioperative management of the adult patient with diabetes, hartmann's solution is used in preference to 0.9% saline. excess use of normal saline could yield complications such as hyperglycemia and metabolic acidosis. to date, a few studies have examined the effects of preoperative blood glucose levels on outcomes in patients undergoing surgery, and no prospective randomized investigations have been reported. the investigators are going to find out if hartmann's solution actually raises postoperative glucose and insulin level by comparing two groups of diabetic patients using either hartmann's solution or normal saline. the investigators expect the result to broaden the choice of fluid for diabetic patients undergoing surgery and hopefully to diminish the side effects manifested by the excess use of normal saline.

Eligibility criteria:
inclusion criteria: * type ii diabetes patients who are included in american society of anesthesiologists physical status classification i-iii. exclusion criteria: * emergency surgery, acute or chronic kidney disease, electrolyte imbalance such as hypernatremia, hyponatremia, hyperkalemia or hypokalemia, liver dysfunction, unexpected hemodynamic instability due to excess bleeding, postoperative ventilatory care and trauma patients.

Keywords: diabetes mellitus, type 2 hartmann's solution
lurasidone - a 6-week study of patients with bipolar i depression (monotherapy)

Conditions: Bipolar Depression

Summary: this clinical study is designed to test the hypothesis that lurasidone is effective, tolerable, and safe for the treatment of patients with bipolar i depression


Eligibility criteria:
inclusion criteria: * subject is diagnosed with bipolar i disorder, most resent episode depressed * subject must have a lifetime history of at least one bipolar manic or mixed episode exclusion criteria: * history of nonresponse to an adequate (6-week) trial of three or more antidepressants (with or without mood stabilizers) during the current episode * subject has been hospitalized for a manic or mixed episode within 60 days prior to randomization * imminent risk of suicide or injury to self, others, or property

Keywords: bipolar i, depression
tolerability and safety of subcutaneous administration of two doses of affitope® pd01a in early parkinson's disease

Conditions: Parkinson's Disease

Summary: this is a phase i study to assess the tolerability and safety of 4 injections of two different doses of affitope® pd01a formulated with an adjuvant to patients with early parkinson's disease in male and female patients aged 45 to 65 years (or age between 40 and 45 years if there is no evidence for genetic forms of the disease and the diagnosis of idiopathic parkinson's disease was confirmed, after approval by sponsor). one study site in vienna (austria) will be involved. each patient's participation will last 1 year. in addition, up to 8 patients will be offered participation within an untreated control group.


Eligibility criteria:
inclusion criteria: * informed consent capability * early pd (≤ 4 years), hoehn\&yahr stages i/ii and fulfill the uk parkinson's disease society brain bank criteria * brain magnetic resonance imaging (mri) scan and dat-spect scan are consistent with the diagnosis of pd * age between 45 and 65 years or age between 40 and 45 years if there is no evidence for genetic forms of the disease and the diagnosis of idiopathic pd was confirmed, after approval by sponsor * caregiver able to attend all visits with patient * stable doses of medications (levodopa (+/- benserazide, carbidopa), comt inhibitors (entacapone, tolcapone), non-ergot dopamine agonists (pramipexol, ropinirol, rotigotine), the mao-b inhibitor rasagiline and amantadine are allowed) exclusion criteria: * women of childbearing potential without birth control or pregnant women * participation in another clinical trial * autoimmune disease or allergy to components of the vaccine * contraindications for mri, dat-spect, colonoscopy including biopsy or lumbar puncture * dementia * history of cancer (exceptions: basal cell carcinoma, intraepithelial cervical neoplasia) * active infectious disease * immunodeficiency * significant systemic illness or psychiatric illness * parkinson-like disease secondary to drug therapy side effects * parkinson-plus syndromes * heredodegenerative disorders * alcoholism or substance abuse * prior treatment with experimental immunotherapeutics for pd including ivig, with immunosuppressive drugs or treatment with deep brain stimulation * venous status rendering it impossible to place an i.v. access
feasibility of supportive care needs in patients with advanced solid cancer in a therapeutic trial

Conditions: Supportive Care; Metastatic Cancer; Clinical Trial

Summary: the purpose of the study is to assess the supportive care needs of patients enrolled in a therapeutic trial for metastatic cancer.

all patients included in a therapeutic trial will be offered an analysis of their supportive care needs from the following options: * dietetics * psychological * pain management * palliative medicine consultation or day hospital * onco-geriatrics * social assistance * physiotherapist care if an intervention(s) is selected, it will be offered in addition to the patient's participation in the therapeutic trial.

Eligibility criteria:
inclusion criteria: * metastatic cancer * patient included in a clinical trial exclusion criteria: - patient deprived of his freedom
cyp2c19 genotype predictor of gastric acid suppression

Conditions: Esophagitis

Summary: if cyp2c19 genotype can predict the efficacy of healing erosive esophagitis and gastric acid secretion in patients taking once a day omeprazole.

proton pump inhibitors are metabolized through the cyp2c19 hepatic enzyme system. several variant genotypes of this enzyme exist which may lead to decreased, normal or increased metabolism of the proton pump inhibitor. with alteration of metabolism, the degree of gastric acid suppression achieved and efficacy in treating reflux could be affected. for example, asian populations who have low activity of cyp2c19, commonly need lower doses of proton pump inhibitors to manage gastroesophageal reflux because of more sustained blood levels and availability of the drug. theoretically, those patients who are rapid metabolizers would receive less effective treatment with proton pump inhibitors

Eligibility criteria:
inclusion criteria: * age 18 or older * have either mild-to-moderate los angeles (la) classification system grade b, moderately severe la grade c, or severe la grade d erosive reflux esophagitis * or patients having a clinically indicated ph/impedance monitoring on proton pump inhibitor therapy for indications of gastroesophageal reflux disease. exclusion criteria: * neoplasm of the esophagus or stomach * use of drugs that interfere with cyp2c19 metabolism diazepam, phenytoin, amitriptyline, clomipramine, clopidogrel cyclophosphamide, progesterone, fluoxetine, fluvoxamine, ketoconazole lansoprazole, omeprazole, ticlopidine * evidence of active h. pylori infection * inability to read due to: blindness, cognitive dysfunction, or english language illiteracy * disorders which predispose to unreliable responses such as schizophrenia, alzheimer's disease or significant memory loss

Keywords: esophagitis
expert system, alimentary

Conditions: Eating Disorder Symptom

Summary: eating disorders (ed) are often undetected in the general population resulting in delayed treatment. the scoff questionnaire has been validated for eating disorders screening in primary care, but does not identify the type of eating disorder. objective: investigators evaluated the performance of a clinical algorithm (expalitm) combining answers to scoff questionnaire with body mass index (bmi) to identify four broad categories of ed derived from dsm-5. design: clinical algorithm (expalitm) was developped from 104 combinations of bmi levels and answers to five scoff questions. two senior ed specialists allocated each combination to one of the four broad categories of ed (dsm-5 diagnostics): restrictive disorder (anorexia nervosa typical, atypical and restrictive food intake disorders), bulimic disorder (typical and with low frequency or duration), hyperphagic disorder (binge eating disorders typical and with low frequency or duration) and other specified ed. the performance of expalitm was evaluated on data from patients referred to the nutrition department including a precise dsm-5 diagnosis of ed, a positive scoff test (at least 2 "yes" answers) and bmi. sensitivity, specificity values with a 95% confidence interval (95% ci) and youden index were calculated for each category.


Eligibility criteria:
inclusion criteria: * eating disorders * scoff test = 2 or more exclusion criteria: * no eating disorders * scoff test = 0 or 1

Keywords: anorexia bulimia
patient education and pap compliance in osa

Conditions: Obstructive Sleep Apnea

Summary: obstructive sleep apnea (osa) is a common disorder with serious complications. positive airway pressure (pap) is the first line treatment of osa, which eliminates obstructive events, reduces daytime sleepiness, and improves quality of life, especially in those with excessive daytime sleepiness. however, despite the benefits of the pap treatment, overall acceptance and adherence rates are not fully promising. less is known regarding the pap adherence rates in turkey. in the current study, the researchers primarily addressed if an intensified patient education strategy including the polysomnography (psg) charts viewing followed by frequent follow-ups would improve the compliance rates at long-term in patients with osa.

osa is a common disorder with serious complications. pap is the first line treatment of osa, but overall acceptance and adherence rates are not fully promising. in the current study, the researchers primarily addressed if an intensified patient education strategy including the psg charts viewing followed by frequent follow-ups would improve the compliance rates at long-term in patients with osa. method: this single-center, randomized, controlled study was conducted at the süreyyapaşa chest diseases and thoracic surgery training and research hospital in istanbul between june 2014 and april 2015. eligible osa patients were randomized to standard support (ss) group (general information about osa and pap treatment at baseline), or to educational support (es) group (additional polysomnography chart viewing from both diagnostic and titration nights). all patients were scheduled to five pap control visits between 2 weeks and 6 months after the pap prescription. primary outcome was the pap compliance (4 h/night for 70% of all the nights) at the last visit.

Eligibility criteria:
inclusion criteria: * consecutive adult patients with newly diagnosed obstructive sleep apnea (apnea-hypopnea index ≥5 events/h), who were offered pap treatment. * must be able to give informed consent exclusion criteria: * disabled to come to follow-ups.

Keywords: sleep apnea positive airway pressure patient education
epidemiology of acute mesenteric ischemia

Conditions: Acute Mesenteric Ischemia

Summary: retrospective population-based study on epidemiology of acute mesenteric ischemia in estonia study objective is to describe epidemiologic features in adult patients with acute mesenteric ischemia during years 2016-2020. patients from all hospitals in estonia are included.


Eligibility criteria:
inclusion criteria: all at least 18-year-old patients with acute mesenteric ischemia during years 2016-2020. exclusion criteria: -
efficacy of omega-3 fatty acids on borderline personality disorder

Conditions: Borderline Personality Disorder.

Summary: borderline personality disorder (bdp) is a serious mental disorder that affects about 1-2% of the general population, and it is characterized by severe psychosocial impairment and a high mortality rate due to suicide. currently, the most effective treatments for bpd are psychotherapy (cognitive behavior therapy - cbt -) and pharmacotherapy (often as an important adjunctive role, especially for diminution of symptoms such as affective instability, impulsivity, psychotic-like symptoms and self-destructive behavior). nevertheless, although several drugs are used in these patients, these drugs induce an improvement of some symptoms but do not cause the remission of bpd. thus, identification of novel treatments is needed. the objective of this study is to examine the efficacy of omacor® ( a mixture of omega-3-acid ethyl esters: eicosapentaenoic acid (epa) and docosahexaenoic acid (dha) ) for bdp patients receiving cbt. patients with bdp will be randomly allocated to the three arms of the study: 1- cbt+placebo, 2- cbt+omacor 1680 mg/d, 3- cbt+omacor 3360 mg/d. follow up will last for 12 weeks. assessment of affective symptoms, impulsivity and aggressivity will be carried out at baseline and at 2, 4, 6, 8, 10 and 12 weeks.


Eligibility criteria:
inclusion criteria: 1. meet dsm-iv criteria for bpd assessed by the structured clinical interview for dsm-iv personality disorders (scid-ii). 2. clinical global impression of severity for bdp \> 3. 3. age between 18 and 65 years. 4. be able to give informed consent for participation. 5. place of residency compatible with the assistance to the center. 6. if woman, use of effective contraception. exclusion criteria: 1. have a serious medical illness. 2. history of omacor® allergy. 3. current diagnostic unipolar depression, bipolar disorder type i, obsessive-compulsive disorder, schizophrenia and other psychotic disorders. 4. dib-r \> 8. 5. suicidal thinking that requires hospital admission. 6. meet dsm-iv criteria for alcohol, benzodiazepine, opioid or psychostimulant dependence in the six months prior to trial entry. 7. transaminase elevation within three times the upper limits of normality. 8. treatment with stable doses of antidepressants or mood stabilizers for less than six weeks. 9. treatment with stable doses of antipsychotics for more than 1 week in the last three months. 10. have received electroconvulsive therapy for the six months prior to trial entry. 11. have received dbt in the last 12 months prior to trial entry. 12. are pregnant or nursing. 13. have participated in any other investigational study in the last 6 months prior to trial entry. 14. current treatment or expectation to start any treatment with drugs that may interact with the study.
physical activity and sports for people with special needs

Conditions: Amputation; Dysmelia; Leg; Deformity, Congenital

Summary: purpose of this study was to assess the balance level of highly qualified amputee football players in relation to their sports level, training experience, position on the pitch, as well as the type of amputation/dysfunction and disability experience.

the participants were presented with the procedure of the study and informed that they could resign from their participation in the study at any stage. all participants were given the written informed consent form after the detailed written and oral explanation of the risk and benefits resulting from participation in this study static balance was assessed using amti accusway stabilographic platform (acs model). the study participants performed the single 10 second left- or right-leg stance with eyes open (eo), and single 10 second left- or right-leg stance with eyes closed (ec) (depending on leg amputation). if the first attempt was not successful, study participants were able to do the second attempt. the tests were conducted on a match-free day, approximately 2 hours after a meal, in a sports outfit, in a specially designated room.

Eligibility criteria:
inclusion criteria: * participant of european amputte football championschip * field player (leg amputation or leg dysfunction) * written consent form exclusion criteria: * goalkeeper * injury * tiredness * refusal

Keywords: amputation amputee football performance balance
neurocognitive effects and tolerability of efavirenz in aging hiv-infected individuals ("shac neuro study")

Conditions: HIV; AIDS

Summary: investigators hypothesize that older hiv-infected individuals (i.e., \>50 years old) on efavirenz (efv)-containing antiretroviral therapy (art) will have significantly worse neurocognitive function than older individuals on non-efv-containing art.

with the aging of the hiv-infected population in the united states and elsewhere, neurocognitive dysfunction will likely become an increasingly common problem. older individuals could be at increased risk for efavirenz-associated adverse effects due to impaired metabolism, increased drug-drug interactions, and lower physiologic reserve, but there are few data on the long-term safety of efavirenz (and other antiretrovirals) in older individuals with hiv. the stanford hiv aging cohort (shac) is an ideal setting to study potential neurologic effects of antiretrovirals in aging patients. shac is an ongoing longitudinal study initiated in 2008 to evaluate aging in virologically-suppressed hiv-infected individuals. the cohort is supported through multiple grants including a grant from the state of california's hiv research program as well as a nih supplemental grant. as of september 2013, approximately 150 virologically-suppressed hiv-infected adults have been enrolled. in addition to enrolling patients with good adherence to art, the cohort purposefully excludes subjects with active substance abuse, unstable medical conditions, and psychiatric illnesses to limit potential confounding the study end points. recently, an nih supplemental grant (ai069556) was received which will expand the shac to 300 hiv-infected subjects. the median age of the subjects in the cohort is in the mid-50's allowing an ample number of older subjects for our planned studies.

Eligibility criteria:
inclusion criteria: * enrollment into shac (stanford hiv aging cohort) * age over 50 years of age * stable antiretroviral therapy containing efv- or pi-containing art (but not both) for at least 6 months * hiv rna levels of \<200 copies/ml for at least 6 months excluding blips (i.e., a single measurement between 200-500 copies/ml preceded and followed by measurements of \<200 copies/ml) while on art. exclusion criteria: * completed treatment for any acute systemic infection (other than hiv-1) less than four weeks before study entry * any active brain infection (except for hiv-1), brain neoplasm, or space-occupying brain lesion. * any active psychiatric illness including schizophrenia, severe depression, or severe bipolar affective disorder that, in the opinion of the investigator, could confound the analysis of the neuropsychological test results. * active drug or alcohol abuse that, in the investigator's opinion, could prevent compliance with study procedures or confound the analysis of study endpoints. * hospitalization within 30 days of study entry * receipt of systemic chemotherapy within 30 days of study entry * unable to provide informed consent

Keywords: hiv aids aging
differential diagnosis of sta-psv in thyrotoxicosis

Conditions: Thyrotoxicosis; Peak Systolic Velocity of Superior Thyroid Artery; Thyroiditis; Graves Disease

Summary: aim: graves's disease and thyroiditis can both characterized with thyrotoxicosis, but their clinical outcome and therapy is quiet different. measurement of iodine uptake is the gold standard to differential diagnosis the thyroiditis or graves's disease. but the iodine uptake is limited for its availability in china and easily influenced by medicine or food contained iodine.the blood pattern of thyroid cfds is useful for differentiate the cause of thyrotoxicosis.most previous studies using the descriptive pattern of thyroid cfds is easily varied by operator subjective judgement. this study is focus on the role of peak systolic velocity of thyroid superior artery in differential diagnosis of thyrotoxicosis. methods: patients with thyrotoxicosis symptoms without recent medicine history were enrolled in two clinical center. its thyroid function, iodine uptake , cfds of thyroid and peak systolic velocity of thyroid superior artery is detected. thyrotoxicosis is defined as tsh level below the low value of normal range. graves disease is defined as the typical symptoms of graves disease such as graves ophthalmopathy or increased iodine uptake. thyroiditis is defined as lack of typical symptoms of graves disease or decreased iodine uptake.we use receiver operator curve(roc) to evaluate its diagnosis value


Eligibility criteria:
inclusion criteria: * newly diagnosed without taking any antithyroid drug or beta receptor blocker with tsh level below the lower limits of reference range * is willing to be enrolled exclusion criteria: * unwilling * taking antithyroid drug or beta receptor blocker * taking foods or medicine rich in iodine in 8 weeks * women with pregnant or lactation
adapalene gel 0.3% in the treatment of atrophic acne scars

Conditions: Acne Scars

Summary: the purpose of this study is to assess the efficacy and safety of adapalene gel 0.3% in the treatment of atrophic acne scars.


Eligibility criteria:
inclusion criteria: * male or female subjects of any race, aged 18 to 50 years inclusive * subjects with a past history of acne and with moderate to severe facial atrophic acne scars exclusion criteria: * subjects with active inflammatory acne lesions * subjects with hypertrophic acne scars